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  1. #1
    Join Date
    Jul. 2, 2005

    Default Financial reality of mental health care.

    In my state in the MidAtlantic, the ability to access decent mental health care belongs to the very poor and the very wealthy. Most mental health professionals, including psychiatrists, participate with any insurance companies. The few who do, receive a paltry amount which has not increased since 1990, when I first went in to private practice.

    I have had discussions for years with those who take private pay only, about how elitist they seem to be. A few say they volunteer a few hours per week, or work at a public facility a few hours a week. Big deal, that doesn't help those who have no choice but to use their insurance.

    I receive more from Medicaid, than I do from 90% of the other insurance companies with whom I participate. Some families have no choice in their insurance plans. Their mental health copays may be as high as $45 per session. Weekly therapy may be financially out of the question.

    If I were single I could not afford to be a social worker. I wish mental health care was as easy to get as guns and rifles are.
    There is no snooze button on a cat that wants breakfast.

    10 members found this post helpful.

  2. #2
    Join Date
    Nov. 2, 2006


    We have never run in to any Providers who weren't happy to take our Blue cross insurance for my husband's therapy visits.

    1 members found this post helpful.

  3. #3
    Join Date
    Jul. 31, 2007


    I know!

    IIRC, lots of health insurance plans are now into short-term therapy. You get 6 or 8 sessions to work out your shizzle. It seems to me that psychological theory adapts. In the 1950s or so, the long relationship developed between therapist and client was at least half of the project/purpose. What happened to that idea?
    The armchair saddler
    Politically Pro-Cat

  4. #4
    Join Date
    May. 6, 2003


    My sister has an adopted child with extremely severe mental health problems (if you've read the blog story entitled "I am Adam Lanza's mother" that's floating around, that should give you a pretty solid idea of what I'm talking about). He is currently in inpatient care due to her having managed to secure a grant. Were it not for that, she would never be able to afford the $10k per month it costs to keep him there and he would be out and about until such time as he went to jail -- and he would go to jail. Not sure if that would happen before he killed her and/or his brothers and sisters, though.
    According to the Mayan calendar, the world will not end this week. Please plan your life accordingly.

  5. #5
    Join Date
    Feb. 20, 2010
    All 'round Canadia


    Quote Originally Posted by mvp View Post
    I know!

    IIRC, lots of health insurance plans are now into short-term therapy. You get 6 or 8 sessions to work out your shizzle. It seems to me that psychological theory adapts. In the 1950s or so, the long relationship developed between therapist and client was at least half of the project/purpose. What happened to that idea?
    Classical psychoanalysis. It's still around, but not really considered mainstream and it is criticized from an evidence-based perspective. More recent schools like CBT focus on coping skills for the here and now, not on digging up every little thing your mother did to you from the time you were born a la Freud, on this looong examination of your childhood.

  6. #6
    Join Date
    Jul. 29, 2006
    Colorado- Yee Haw!


    I used the short term offering in my health plan for marriage counseling this year and found four sessions amazingly effective! I still have no idea what happened that made a difference- but it really did. I felt like the therapist also kind of pushed us to stop at four (maybe so we would have 4 left if we needed them later in the year?)

    That was probably the best bang for the buck my company could have spent on keeping me a focused employee. I would guess the same effect is true for helping kids that are not doing well allowing parents to focus at work. As a country we really undervalue mental health.

    1 members found this post helpful.

  7. #7
    Join Date
    Feb. 25, 2012


    Every provider I know takes BC/BS, and most other insurance.

    Out here one cannot afford to only take private pay.

    And most of us take a few $30/hour clients as well!

    And have to pay for malpractice insurance, office rent, the outrageous costs to keep our testing materials updated, go to trainings and keep up with CEUs and so on.

    Medicaid pays a whopping $57/hour. And while you might think its better than a poke in the eye, after completign all the paperwork, doing all the referral calls and contacts, and taking phone calls(can't bill for) and so on, many practitioners lose money on medicaid. We take it though,just so people can get care.

    Medicare without a supplement still leaves clients on the hook for around $50 per session (pays $37/hour). Obviously one cannot run a practice on medicaid/medicare clients unless one jus goes by volume (and I would argue that the quality really suffers at that point, mine would anyway).
    I hope (but doubt) that as a result of the shooting people might think maybve those "cuts in medicare that no one notices" (except us in mental health!) might be worth looking at!

    And yes, inpatient is outrageous. I called a private treatment center for a client and was told they were $45,000 a month and did not take insurance!!!!! Who has money for that???

    2 members found this post helpful.

  8. #8
    Join Date
    Dec. 1, 1999
    flyover country

    Default All of these are very interestring

    But it still doesn't explain the explosion of mentally unstable people out there. I know they have always been around, but not in the numbers they are now.
    I read that horrifying article, 'I am Adam Lanza'a mother' and I know there are many many more. Where did they come from? What is the cause?
    Another killer of threads

  9. #9
    Join Date
    Mar. 18, 2007

    Default This is dysfunctional

    This country is broken. Let's spend billions defending oil fields for Exxon, and let ourselves and our neighbors beg for care. It almost makes one wonder why there aren't more mass killings.

  10. #10
    Join Date
    Jan. 10, 2008
    Western NY


    My parents had health care on- and off-again when I was a kid. Generally one of them was working and the other was unemployed, so we were always just enough out of poverty to not qualify for any public health programs, but frequently neither of them had much in the way of benefits. When I was a teenager and having issues with anxiety and depression, I got three sessions with a counselor, but that was all my dad's insurance would pay for... just enough to start kind of trusting the counselor. Now, I've been having issues with my anxiety again and with grief, but my husband's health insurance is craptastic. I at least got on the waiting list for the local university counseling services department, but it may be a few months before I can actually see someone.

  11. #11
    Join Date
    Jun. 20, 2009
    Northeast Ohio, where mud rules your world...


    My theory on mental health, for what it's worth which ain't much.

    The brain is a very complex organ with a mysterious amount of chemistry spewing around inside it. When we began to evolve higher thought, our brains went farther then the basic survivalist skills. we began to grasp the higher levels of community and all the deeper emotional questions about individuals living happily within that community.

    Fast forward to now - it's a simple as looking at the numbers of population. More peeps equals more chance for malfunction. We have chosen to move our daily existance away from living within the natural elements of nature. We build shelters, cities, technology so we could live comfortably in a stable environment indoors while Nature's weather and all it's harshness of life could rage on outside the windows. But our brains are still hard wired to live in community.

    Instant access and gratification through technological advances have skewed our perception of passing time, what hard work for reward is, and the knowledge of the world around us. We have much more instant and freer access to the good, bad, and ugly out there. I feel the internet has been a game changer. Mental instability has ALWAYS been a part of our chemistry. It's a genetic puzzle who gets dealt the crappy cards. But our civilization's choices for ALL have changed the environment in which those card holders have had to live in. Now, anyone with a computer can have unsupervized access to knowledge they would otherwise not been in contact with. We used to be able to shelter our children from the ugliness of the world. We could keep them children longer. To find out about the world around them, it had to be concrete, reachable, within their grasp. This includes something happening directly to them or someone they know (domestic violence), magazines and tv (smut mags under bro's mattress or late night tv at a friend's house). You were able to balance your parenting with what community you lived in.

    Now, every house has pay tv. Every kid has access to the internet. And if your kid doesn't, the kid they sit next to on the bus does.

    Mental health needs a balanced environment. Our society is not balanced right now. It's too easy for anyone to gain access to knowledge they aren't mature enough to understand or make opinions on. (Kids and the internet, with all it's ugliness about grown up crap) Most kids will just grow up, muddle through and be fine. But those with the brewings of misfiring brain chemistry will store away those confusing messages. And when they have reached a level of such complete irrational thought while trying to deal with their sadness and anger, they will reach deep into their cortex and find those confusing messages. They will find the hours and hours of violent images they saw when they were young. They will find the words spoken around them of adults saying things that kids shouldn't hear. They will feel that disconnect from their parents and their community that this plugged in age has fostered.

    The misfiring of brain chemistry has been a part of the human condition since we stood our ugly asses up on two legs and started to think deep thoughts. It's the overwhelming bad odds that overpopulation and indiscriminant breeding of our species has allowed (don't panic, i'm talking about how living indoors has helped us avoid the Strongest Survive syndrome. Weak humans succumb to death and disease before science, shelter, and civilization prevented it) And our insistance on a living environment with no filter to things we aren't ready to understand at young ages has also filled the minds with confusion.

    When those singular humans pass through their individual lives, it is merely a pebble in a puddle rippling out the waves that align all things up just right for one of those individuals to stop our society in it's tracks with their actions.

    Managing mental health is long and complicated. Raising children takes work, a lifetime with much of it being in the formative years. Doing what is right instead of what is easy takes conscience effort. People get tired, lazy, lulled, overwhelmed. Time passes and life drags on.

    Managing our society at the sheer size and numbers that it has become is an exhausting process. It is overwhelming but if we look at the individuals within our reach it can be done. Make a vow to look around you and be responsible for those in your line of sight. Look out for each other. Be a part of your community, not an island unto yourself. Give back. Do without so others may have something. And above all, think about not just what you are teaching your children because it works right for you. Teach your children so that it works for them. Teach your children for the greater good of your community and society as a whole. Remember that everything your children sees, hears, eats, watches, does has the ability to affect who they are and how they feel.

    the toughest choice in life is to give up something for yourself, something that you are perfectly happy with and capable of managing, for the greater good of the whole.

    I sympathize with those around me that need mental health pros but don't have easy access to them through conventional means. Those people need someone standing next to them who is of sound mind to overturn the stones, find out of the box alternatives for that person to get help in unconventional ways that our beaurocratic health care system has made impossible to access. Ironically, the best medicine after pharmecutical intervention for most issues, is contact with another human being. Why do you think most mental health care providers don't text or email your talk sessoin!! Because it's not the same. We are hard wired to be a community with human contact through sight, touch, voice.....

    Start with unplugging yourself and your family from the electronics. Learn to live in each other's presense again. Tune into the people around you and I guarantee we all will see the signs of mental breakdown long before it gets ugly. I guarantee with getting back intouch with the human condition again, reaching out to a fellow in need won't feel awkward or wrong. Pare down your life so that you are available to those around you again. People with mental health needs need People!!!!
    ...don't sh** where you eat...

    3 members found this post helpful.

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